U.S. patent number 10,987,229 [Application Number 15/896,936] was granted by the patent office on 2021-04-27 for spinal implant system.
This patent grant is currently assigned to WARSAW ORTHOPEDIC, INC.. The grantee listed for this patent is Warsaw Orthopedic, Inc. Invention is credited to Robert M. Loke, Julien J. Prevost, Thomas J. Stinchfield.
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United States Patent |
10,987,229 |
Stinchfield , et
al. |
April 27, 2021 |
Spinal implant system
Abstract
A spinal implant system is provided for bridging an
intervertebral space between vertebral bodies bordering the
intervertebral space. The spinal implant system includes at least
one adjustable end cap and a spinal implant. The end cap can be
used with additional end caps and/or the spinal implant. Multiple
end caps can be stacked on top of one another, and one end cap can
be attached to a first end of the spinal implant, and another end
cap 10 can be attached to a second end of the spinal implant. Thus,
one or more of the end caps can be attached to either end of the
spinal implant.
Inventors: |
Stinchfield; Thomas J.
(Germantown, TN), Prevost; Julien J. (Memphis, TN), Loke;
Robert M. (Memphis, TN) |
Applicant: |
Name |
City |
State |
Country |
Type |
Warsaw Orthopedic, Inc |
Warsaw |
IN |
US |
|
|
Assignee: |
WARSAW ORTHOPEDIC, INC.
(Warsaw, IN)
|
Family
ID: |
1000005512869 |
Appl.
No.: |
15/896,936 |
Filed: |
February 14, 2018 |
Prior Publication Data
|
|
|
|
Document
Identifier |
Publication Date |
|
US 20190247199 A1 |
Aug 15, 2019 |
|
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61F
2/44 (20130101); A61F 2/4465 (20130101); A61F
2/446 (20130101); A61F 2/4425 (20130101); A61F
2002/30507 (20130101); A61F 2002/448 (20130101); A61F
2002/30523 (20130101); A61F 2002/4415 (20130101); A61F
2002/3055 (20130101); A61B 17/7059 (20130101); A61B
2017/0256 (20130101); A61F 2002/30224 (20130101); A61F
2/4455 (20130101); A61F 2002/443 (20130101); A61F
2/442 (20130101); A61F 2002/30495 (20130101); A61F
2002/30538 (20130101) |
Current International
Class: |
A61F
2/44 (20060101); A61B 17/70 (20060101); A61B
17/02 (20060101); A61F 2/30 (20060101) |
Field of
Search: |
;623/17.11-17.16 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Other References
International Search Report and Written Opinion for
PCT/US2019/017576 the counterpart application dated May 29, 2019,
12 pages. cited by applicant.
|
Primary Examiner: Shirsat; Marcela I.
Claims
We claim:
1. A spinal implant system comprising: a spinal implant having a
first end, an opposite second end, a height extending between the
first end and the second end, the spinal implant including a first
flange portion provided at the first end, a second flange portion
provided at the second end, a first recess provided adjacent the
first flange portion, and a second recess provided adjacent the
second flange portion, the first flange portion and the second
flange portion each including a perimeter surface extending at
least partially along the first flange portion and the second
flange portion, respectively; and an end cap having a first end and
an opposite second end, the end cap having a base portion including
a lower portion and an upper portion, the lower portion being
provided at the first end of the end cap, and the upper portion
extending from the lower portion to adjacent the second end of the
end cap, the lower portion including a first end, an opposite
second end, a perimeter, a mid-longitudinal axis extending through
the first end and the second end, a lower surface, and a plurality
of sidewall portions, the plurality of sidewall portions of the
lower portion being spaced apart from one another adjacent the
perimeter of the lower portion, the plurality of sidewall portions
of the lower portion including inner surfaces, and at least two of
the plurality of sidewall portions of the lower portion being
spaced apart from one another across a portion of the lower
surface, the lower surface and the inner surfaces of the plurality
of sidewall portions of the lower portion defining a first cavity,
the inner surfaces of at least two of the plurality of sidewall
portions of the lower portion each including a tab extending into
the first cavity, and the lower portion having a maximum dimension
perpendicular to the mid-longitudinal axis of the lower portion in
a first plane extending through the plurality of sidewall portions,
and the upper portion including a first end, an opposite second
end, a mid-longitudinal axis extending through the first end and
the second end of the upper portion, and an exterior surface
extending between the first end and the second end, the first end
of the upper portion being attached to the lower portion, the upper
portion having a maximum dimension perpendicular to the
mid-longitudinal axis of the upper portion in a second plane
extending through the exterior surface that is less than the
maximum dimension of the lower portion, the exterior surface
including a tapered portion adjacent the second end of the upper
portion having a first step portion and a second step portion, and
the tapered portion residing in a third plane and a fourth plane
that are perpendicular to the mid-longitudinal axis of the upper
portion, the tapered portion having a maximum dimension in the
third plane extending through the first step portion, and a maximum
dimension in the fourth plane extending through the second step
portion, the maximum dimension in the fourth plane being less than
the maximum dimension in the first one of the various planes, and
the second step portion being closer to the second end than the
first step portion, the end cap having a body portion including a
sidewall portion, a third flange portion, and a third recess, the
sidewall portion extending from adjacent the first end of the end
cap to adjacent the second end of the end cap, the third flange
portion being provided at the second end of the end cap, and the
third recess provided in the sidewall portion adjacent the third
flange, the sidewall portion having a mid-longitudinal axis and
defining an interior cavity for receiving a portion of the upper
portion of the base portion, the interior cavity having an
engagement surface therein for contacting at least a portion of the
tapered portion of the upper portion of the base portion; wherein
the body portion is positionable with respect to the base portion
by adjusting the position of the engagement surface of the interior
cavity of the body portion on the tapered portion of the upper
portion of the base portion; and wherein the first cavity of the
end cap is configured to receive one of the first flange portion of
the spinal implant and the second flange portion of the spinal
implant, the tabs of the end cap being received in one of the first
recess and the second recess corresponding to the one of the first
flange and the second flange to facilitate attachment of the end
cap to the spinal implant.
2. The spinal implant system of claim 1, wherein each of the at
least two of the plurality of sidewall portions of the lower
portion including the tabs are moveable between a first position
where the tabs are received in the one of the first recess and the
second recess, and a second position that allows the one of the
first flange portion and the second flange portion to pass thereby,
the at least two of the plurality of sidewall portions of the lower
portion each being resiliently biased to the first position.
3. The spinal implant system of claim 1, wherein the end cap is
rotatably attached to the spinal implant and capable of rotation by
rotating the first cavity with respect to the one of the first
flange and the second flange.
4. The spinal implant system of claim 1, wherein the spinal implant
is expandable between an unexpanded configuration and an expanded
configuration, expansion of the spinal implant increasing the
height thereof.
5. The spinal implant system of claim 1, wherein the sidewall
portion of the body portion includes an exterior surface and an
aperture extending from the exterior surface to the interior
cavity, and the end cap further comprises a fastener received in
the aperture for impinging on the upper portion of the base
portion, impingement of the fastener on the exterior surface of the
upper portion of the base portion serving to fix the position of
the body portion with respect to the base portion.
6. The spinal implant system of claim 1, wherein the third flange
portion includes an upper surface, and the upper surface of third
flange portion moves relative to the mid-longitudinal axis of the
upper portion at least .+-.10 degrees via positioning of the body
portion relative to the base portion.
7. The spinal implant system of claim 1, wherein the
mid-longitudinal axis of the sidewall portion is moveable relative
to mid-longitudinal axis of the upper portion at least .+-.10
degrees via positioning of the body portion relative to the base
portion.
8. The spinal implant system of claim 1, wherein portions of the
engagement surface are arcuate in a first plane and a second plane
extending through the mid-longitudinal axis of the sidewall
portion.
9. A spinal implant system comprising: a spinal implant having a
first end, an opposite second end, a height extending between the
first end and the second end, the spinal implant including a first
flange portion provided at the first end, a second flange portion
provided at the second end, a first recess provided adjacent the
first flange portion, and a second recess provided adjacent the
second flange portion; and an end cap having a first end and an
opposite second end, the end cap having a base portion including a
lower portion and an upper portion, the lower portion being
provided at the first end of the end cap, and the upper portion
extending from the lower portion to adjacent the second end of the
end cap, the lower portion including a first end, an opposite
second end, a perimeter, a mid-longitudinal axis extending through
the first end and the second end, a lower surface, and a plurality
of sidewall portions, the plurality of sidewall portions of the
lower portion being positioned around the perimeter of the lower
portion, and the plurality of sidewall portions of the lower
portion including inner surfaces, the lower surface and the inner
surfaces of the plurality of sidewall portions of the lower portion
defining a first cavity, and the lower portion having a maximum
dimension perpendicular to the mid-longitudinal axis of the lower
portion in a first plane extending through the plurality of
sidewall portions, and the upper portion including a first end, an
opposite second end, a mid-longitudinal axis extending through the
first end and the second end of the upper portion, and an exterior
surface extending between the first end and the second end, the
first end of the upper portion being attached to the lower portion,
the upper portion having a maximum dimension perpendicular to the
mid-longitudinal axis of the upper portion in a second plane
extending through the exterior surface that is less than the
maximum dimension of the lower portion, the exterior surface
including a tapered portion adjacent the second end of the upper
portion having a first step portion and a second step portion, and
the tapered portion residing in a third plane and a fourth plane
that are perpendicular to the mid-longitudinal axis of the upper
portion, the tapered portion having a maximum dimension in the
third plane extending through the first step portion, and a maximum
dimension in the fourth plane extending through the second step
portion, the maximum dimension in the fourth plane being less than
the maximum dimension in the first one of the various planes, and
the second step portion being closer to the second end than the
first step portion, the end cap having a body portion including a
sidewall portion, a third flange portion, and a third recess, the
sidewall portion extending from adjacent the first end of the end
cap to adjacent the second end of the end cap, the third flange
portion being provided at the second end of the end cap, and the
third recess provided in the sidewall portion adjacent the third
flange, the sidewall portion having a mid-longitudinal axis and
defining an interior cavity for receiving a portion of the upper
portion of the base portion, the interior cavity having an
engagement surface therein for contacting at least a portion of the
tapered portion of the upper portion of the base portion; wherein
the body portion is positionable with respect to the base portion
by adjusting the position of the engagement surface of the interior
cavity of the body portion on the tapered portion of the upper
portion of the base portion; and wherein the first cavity of the
end cap is configured to receive one of the first flange portion of
the spinal implant and the second flange portion of the spinal
implant.
10. The spinal implant system of claim 9, wherein each of the at
least two of the plurality of sidewall portions of the lower
portion are moveable between a first position and a second position
that allows the one of the first flange portion and the second
flange portion to pass thereby.
11. The spinal implant system of claim 9, wherein the end cap is
rotatably attached to the spinal implant and capable of rotation by
rotating the first cavity with respect to the one of the first
flange and the second flange.
12. The spinal implant system of claim 9, wherein the spinal
implant is expandable between an unexpanded configuration and an
expanded configuration, expansion of the spinal implant increasing
the height thereof.
13. The spinal implant system of claim 9, wherein the sidewall
portion of the body portion includes an exterior surface and an
aperture extending from the exterior surface to the interior
cavity, and the end cap further comprises a fastener received in
the aperture for impinging on the upper portion of the base
portion, impingement of the fastener on the exterior surface of the
upper portion of the base portion serving to fix the position of
the body portion with respect to the base portion.
14. The spinal implant system of claim 9, wherein the third flange
portion includes an upper surface, and the upper surface of third
flange portion moves relative to the mid-longitudinal axis of the
upper portion at least .+-.10 degrees via positioning of the body
portion relative to the base portion.
15. The spinal implant system of claim 9, wherein the
mid-longitudinal axis of the sidewall portion is moveable relative
to the mid-longitudinal axis of the upper portion at least .+-.10
degrees via positioning of the body portion relative to the base
portion.
16. The spinal implant system of claim 9, wherein portions of the
engagement surface are arcuate in a first plane and a second plane
extending through the mid-longitudinal axis of the sidewall
portion.
17. A spinal implant system comprising: a spinal implant having a
first end, an opposite second end, a height extending between the
first end and the second end, the spinal implant including a first
flange portion provided at the first end, a second flange portion
provided at the second end, a first recess provided adjacent the
first flange portion, and a second recess provided adjacent the
second flange portion; and an end cap having a first end and an
opposite second end, the end cap having a base portion including a
lower portion and an upper portion, the lower portion being
provided at the first end of the end cap, and the upper portion
extending from the lower portion to adjacent the second end of the
end cap, the lower portion including a first end, an opposite
second end, a perimeter, a mid-longitudinal axis extending through
the first end and the second end, a lower surface, and a plurality
of sidewall portions, the plurality of sidewall portions of the
lower portion being positioned around the perimeter of the lower
portion, and the plurality of sidewall portions of the lower
portion including inner surfaces, the lower surface and the inner
surfaces of the plurality of sidewall portions of the lower portion
defining a first cavity, and the lower portion having a maximum
dimension perpendicular to the mid-longitudinal axis of the lower
portion in a first plane extending through the plurality of
sidewall portions, and the upper portion including a first end, an
opposite second end, a mid-longitudinal axis extending through the
first end and the second end of the upper portion, and an exterior
surface extending between the first end and the second end, the
first end of the upper portion being attached to the lower portion,
the upper portion having a maximum dimension perpendicular to the
mid-longitudinal axis of the upper portion in a second plane
extending through the exterior surface that is less than the
maximum dimension of the lower portion, the exterior surface
including a tapered portion adjacent the second end of the upper
portion having a first step portion and a second step portion, and
the tapered portion residing in a third plane and a fourth plane
that are perpendicular to the mid-longitudinal axis of the upper
portion, the tapered portion having a maximum dimension in the
third plane extending through the first step portion, and a maximum
dimension in the fourth plane extending through the second step
portion, the maximum dimension in the fourth plane being less than
the maximum dimension in the first one of the various planes, and
the second step portion being closer to the second end than the
first step portion, the end cap having a body portion including a
sidewall portion, a third flange portion, and a third recess, the
sidewall portion extending from adjacent the first end of the end
cap to adjacent the second end of the end cap, the third flange
portion being provided at the second end of the end cap, and the
third recess provided in the sidewall portion adjacent the third
flange, the sidewall portion having a mid-longitudinal axis and
defining an interior cavity for receiving a portion of the upper
portion of the base portion, the interior cavity having an
engagement surface therein for contacting at least a portion of the
tapered portion of the upper portion of the base portion, and
portions of the engagement surface being arcuate in a first plane
and a second plane extending through the mid-longitudinal axis of
the sidewall portion; wherein the body portion is positionable with
respect to the base portion by adjusting the position of the
engagement surface of the interior cavity of the body portion on
the tapered portion of the upper portion of the base portion, and
edges of the first step portion and the second step portion contact
the engagement surface; and wherein the first cavity of the end cap
is configured to receive one of the first flange portion of the
spinal implant and the second flange portion of the spinal
implant.
18. The spinal implant system of claim 17, wherein the sidewall
portion of the body portion includes an exterior surface and an
aperture extending from the exterior surface to the interior
cavity, and the end cap further comprises a fastener received in
the aperture for impinging on the upper portion of the base
portion, impingement of the fastener on the exterior surface of the
upper portion of the base portion serving to fix the position of
the body portion with respect to the base portion.
19. The spinal implant system of claim 17, wherein the third flange
portion includes an upper surface, and the upper surface of third
flange portion moves relative to the mid-longitudinal axis of the
upper portion at least .+-.10 degrees via positioning of the body
portion relative to the base portion.
20. The spinal implant system of claim 17, wherein the
mid-longitudinal axis of the sidewall portion is moveable relative
to the mid-longitudinal axis of the upper portion at least .+-.10
degrees via positioning of the body portion relative to the base
portion.
Description
BACKGROUND OF THE INVENTION
The present invention relates to a spinal implant system employing
an end cap for use with additional end caps and/or a spinal implant
or spinal implants. More particularly, the present invention
relates to a modular spinal implant system using an end cap that
can be attached to additional end caps and/or a spinal implant to
increase the height of the modular spinal implant system so that
the system is sized appropriately for an intervertebral space. More
specifically, the present invention relates to a modular spinal
implant system that allows one or more adjustable end caps to be
stacked on either end of a spinal implant or spinal implants to
increase the height of the spinal implant system, and allows the
adjustable end caps to be adjusted to create angularity between an
upper surface and a lower surface of the spinal implant system.
Spinal disorders oftentimes requires removal of one or more
vertebral bodies from the spine of a patient. An intervertebral
space between the remaining vertebral bodies is typically bridged
by instrumentation to stabilize the spine. Various spinal implants
such as, for example, corpectomy devices, whether unexpandable or
expandable, typically have been used as the instrumentation to
stabilize the spine. Such corpectomy devices can have end portions
that afford angular adjustment so that the angularity between an
upper surface and a lower surface of the corpectomy device can be
adjusted.
However, there is a need for additional adjustability of the height
and/or the angularity of the ultimate construct for implantation in
the intervertebral space. The present invention is directed to one
or more end caps that can be attached to either an unexpandable or
an expandable spinal implant to provide for a spinal implant
system. One or more of the end caps can be attached to either of
the ends of the spinal implant to increase the height of the spinal
implant system, and the one or more end caps each can have angular
adjustment features that allow the angularity between an upper
surface and a lower surface of the spinal implant system to be
adjusted. As such, the configuration of the spinal implant system
provided by the one or more end caps can be adjusted to fit the
intervertebral space.
SUMMARY OF THE INVENTION
The present invention in one preferred embodiment contemplates a
spinal implant system including a spinal implant having a first
end, an opposite second end, a height between the first end and the
second end, the spinal implant including a first flange portion
provided at the first end, a second flange portion provided at the
second end, a first recess provided adjacent the first flange
portion, and a second recess provided adjacent the second flange
portion, the first flange portion and the second flange portion
each including a perimeter surface extending at least partially
along the first flange portion and the second flange portion; and
an end cap having a first end and an opposite second end, the end
cap having a base portion including a lower portion and an upper
portion, the lower portion being provided at the first end of the
end cap, and the upper portion extending from the lower portion to
adjacent the second end of the end cap, the lower portion including
a perimeter, a lower surface, and a plurality of sidewall portions,
the plurality of sidewall portions being spaced apart from one
another adjacent the perimeter of the lower portion, at least two
of the plurality of sidewall portions being spaced apart from one
another across a portion of the lower surface, the lower surface
and inner surfaces of the plurality of sidewall portions defining a
first cavity, and the inner surfaces of at least two of the
plurality of sidewall portions each including a tab extending into
the first cavity, and the upper portion including a first end, an
opposite second end, a first mid-longitudinal axis extending
through the first end and the second end, and an exterior surface
portion extending between the first end and the second end, the
first end of the upper portion being attached to the lower portion,
and the exterior surface portion including a tapered portion
adjacent the second end of the upper portion, the end cap having a
body portion including a sidewall portion, a third flange portion,
and a third recess, the sidewall portion extending from adjacent
the first end of the end cap to adjacent the second end of the end
cap, the third flange portion being provided at the second end of
the end cap, and the third recess provided in the sidewall portion
adjacent the third flange, the sidewall portion having a second
mid-longitudinal axis and defining an interior cavity for receiving
a portion of the upper portion of the base portion, the interior
cavity having an engagement surface therein for contacting at least
a portion of the tapered portion of the upper portion of the base
portion; where the body portion is positionable with respect to the
base portion by adjusting the position of the engagement surface of
the interior cavity of the body portion on the tapered portion of
the upper portion of the base portion; and where the first cavity
of the end cap is configured to receive one of the first flange
portion of the spinal implant and the second flange portion of the
spinal implant, the tabs of the end cap being received in one of
the first recess and the second recess corresponding to the one of
the first flange and the second flange to facilitate attachment of
the end cap to the spinal implant.
The present invention in another preferred embodiment contemplates
a spinal implant system including a spinal implant having a first
end, an opposite second end, and a height between the first end and
the second end, the spinal implant including a first flange portion
provided at the first end, a second flange portion provided at the
second end, a first recess provided adjacent the first flange
portion, and a second recess provided adjacent the second flange
portion, the first flange portion and the second flange portion
each including a perimeter surface extending at least partially
along the first flange portion and the second flange portion; a
first end cap having a first end and an opposite second end, the
first end cap having a first base portion including a lower portion
and an upper portion, the lower portion of the first base portion
being provided at the first end of the first end cap, and the upper
portion of the first base portion extending from the lower portion
of the first base portion to adjacent the second end of the first
end cap, the lower portion of the first base portion including a
perimeter, a lower surface, and a plurality of sidewall portions,
the plurality of sidewall portions of the lower portion of the
first base portion being spaced apart from one another adjacent the
perimeter of the lower portion of the first base portion, at least
two of the plurality of sidewall portions of the lower portion of
the first base portion being spaced apart from one another across a
portion of the lower surface, the lower surface of the lower
portion of the first base portion and inner surfaces of the
plurality of sidewall portions of the lower portion of the first
base portion defining a first cavity, and the inner surfaces of at
least two of the plurality of sidewall portions of the lower
portion of the first base portion each including a tab extending
into the first cavity, and the upper portion of the first base
portion including a first end, an opposite second end, and an
exterior surface portion extending between the first end and the
second end of the upper portion of the first base portion, the
first end of the upper portion of the first base portion being
attached to the lower portion of the first base portion, and the
exterior surface portion of the upper portion of the first base
portion including a tapered portion adjacent the second end of the
upper portion of the first base portion, the first end cap having a
first body portion including a sidewall portion, a third flange
portion, and a third recess, the sidewall portion of the first body
portion extending from adjacent the first end of the first end cap
to adjacent the second end of the first end cap, the third flange
portion of the first body portion being provided at the second end
of the first end cap, and the third recess of the first body
portion provided in the sidewall portion of the first body portion
adjacent the third flange portion of the first body portion, the
sidewall portion of the first body portion defining an interior
cavity for receiving a portion of the upper portion of the first
base portion, the interior cavity of the first body portion having
an engagement surface therein for contacting at least a portion of
the tapered portion of the upper portion of the first base portion;
and a second end cap having a first end and an opposite second end,
the second end cap having a second base portion including a lower
portion and an upper portion, the lower portion of the second base
portion being provided at the first end of the second end cap, and
the upper portion of the second base portion extending from the
lower portion of the second base portion to adjacent the second end
of the second end cap, the lower portion of the second base portion
including a perimeter, a lower surface, and a plurality of sidewall
portions, the plurality of sidewall portions of the lower portion
of the second base portion being spaced apart from one another
adjacent the perimeter of the lower portion of the second base
portion, at least two of the plurality of sidewall portions of the
lower portion of the second base portion being spaced apart from
one another across a portion of the lower surface of the lower
portion of the second base portion, the lower surface and inner
surfaces of the plurality of sidewall portions of the lower portion
of the second base portion defining a second cavity, and the inner
surfaces of at least two of the plurality of sidewall portions of
the lower portion of the second base portion each including a tab
extending into the second cavity, and the upper portion of the
second base portion including a first end, an opposite second end,
and an exterior surface portion extending between the first end and
the second end of the upper portion of the second base portion, the
first end of the upper portion of the second base portion being
attached to the lower portion of the second base portion, and the
exterior surface portion of the upper portion of the second base
portion including a tapered portion adjacent the second end of the
upper portion of the second base portion, the second end cap having
a second body portion including a sidewall portion, a fourth flange
portion, and a fourth recess, the sidewall portion of the second
body portion extending from adjacent the first end of the second
end cap to adjacent the second end of the second end cap, the
fourth flange portion of the second body portion being provided at
the second end of the second end cap, and the fourth recess of the
second body portion provided in the sidewall portion of the second
body portion adjacent the fourth flange portion of the second body
portion, the sidewall portion of the second body portion defining
an interior cavity for receiving a portion of the upper portion of
the second base portion, the interior cavity of the second body
portion having an engagement surface therein for contacting at
least a portion of the tapered portion of the upper portion of the
second base portion; where the first cavity of the first end cap is
configured to receive one of the first flange portion of the spinal
implant and the second flange portion of the spinal implant, and
the second cavity of the second end cap is configured to receive
the third flange portion of the first end cap, or the other of the
first flange portion and the second flange portion, the tabs of the
first end cap being received in one of the first recess and the
second recess corresponding to the one of the first flange portion
and the second flange portion to facilitate attachment of the first
end cap to the spinal implant, and the tabs of the second end cap
being received in the third recess or the other of the first recess
and the second recess corresponding to the third flange portion or
the other of the first flange portion and the second flange portion
to facilitate attachment of the second end cap to the first end cap
or the spinal implant.
The present invention in yet another preferred embodiment
contemplates a method of sizing for and inserting in an
intervertebral space componentry of a spinal implant system, the
method including determining a distance and an angularity between
vertebral bodies bordering an intervertebral space; selecting an
expandable spinal implant and at least one end cap sized to fill
the distance between the intervertebral space; the spinal implant
having a first end, an opposite second end, and a height between
the first end and the second end, the spinal implant including a
first flange portion provided at the first end, a second flange
portion provided at the second end, a first recess provided
adjacent the first flange portion, and a second recess provided
adjacent the second flange portion, the first flange portion and
the second flange portion each including a perimeter surface
extending at least partially along the first flange portion and the
second flange portion, and a end cap having a first end and an
opposite second end, the end cap having a base portion including a
lower portion and an upper portion, the lower portion being
provided at the first end of the end cap, and the upper portion
extending from the lower portion to adjacent the second end of the
end cap, the lower portion including a perimeter, a lower surface,
and a plurality of sidewall portions, the plurality of sidewall
portions being spaced apart from one another adjacent the perimeter
of the lower portion, at least two of the plurality of sidewall
portions being spaced apart from one another across a portion of
the lower surface, the lower surface and inner surfaces of the
plurality of sidewall portions defining a first cavity, and the
inner surfaces of at least two of the plurality of sidewall
portions each including a tab extending into the first cavity, and
the upper portion including a first end, an opposite second end, a
first mid-longitudinal axis extending through the first end and the
second end, and an exterior surface portion extending between the
first end and the second end, the first end of the upper portion
being attached to the lower portion, and the exterior surface
portion including a tapered portion adjacent the second end of the
upper portion, the end cap having a body portion including a
sidewall portion and a third flange portion, the sidewall portion
extending from adjacent the first end of the end cap to adjacent
the second end of the end cap, and the third flange portion being
provided at the second end of the end cap, the sidewall portion
having an interior cavity for receiving a portion of the upper
portion of the base portion, the interior cavity having an
engagement surface therein for contacting at least a portion of the
tapered portion of the upper portion of the base portion, attaching
the end cap to one of the first flange portion and the second
flange portion by receiving the one of the first flange portion and
the second flange portion in the first cavity and inserting the
tabs of the at least two of the plurality of sidewall portions into
one of the first recess and the second recess corresponding to the
one of the first flange and the second flange; and inserting the
expandable spinal implant and the end cap attached thereto into the
intervertebral space by contacting the third flange portion of the
end cap with one of the vertebral bodies bordering the
intervertebral space, and contacting the other of the first flange
portion and the second flange portion with the other of the
vertebral bodies bordering the intervertebral space.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a top front perspective view of an end cap according to
an embodiment of the present invention, the end cap including a
base portion and a body portion that are adjustable with respect to
one another;
FIG. 1A is a top front perspective view of the base portion of the
end cap of FIG. 1;
FIG. 2 is a bottom front perspective view of the end cap of FIG.
1;
FIG. 3 is a front elevational view of the end cap of FIG. 1;
FIG. 4 is a cross-sectional view of the end cap of FIG. 1 taken
along Line 4-4 of FIG. 3;
FIG. 4A is a cross-sectional view similar to that of FIG. 4 showing
the body portion in a first orientation with respect to the base
portion;
FIG. 4B is a cross-sectional view similar to that of FIG. 4 showing
the body portion in a second orientation with respect to the base
portion;
FIG. 5 is a cross-sectional view of the end cap of FIG. 1 taken
along Line 5-5 of FIG. 3;
FIG. 6 is a front elevational view of various end caps of FIG. 1
stacked on top of one another;
FIG. 7 is a top front perspective view of a corpectomy device
usable together with the end cap of FIG. 1;
FIG. 8 is a top front exploded perspective view of the end cap of
FIG. 1 positioned for attachment to the corpectomy device of FIG.
7;
FIG. 9 is a cross-sectional view of the end cap of FIG. 1 and a
portion of the corpectomy device of FIG. 7, where the end cap is
positioned for attachment to the corpectomy device;
FIG. 10 is a front elevational view of another end cap of FIG. 1
being attached to the corpectomy device of FIG. 7; and
FIG. 11 is a front elevational view of the another end cap of FIG.
1 attached to the corpectomy device of FIG. 7.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
A spinal implant system according to an embodiment of the present
invention is disclosed in FIGS. 1-11. The spinal implant system is
employed, for example, with a surgical procedure, including
percutaneous, mini-open, and open surgical techniques to deliver
and introduce instrumentation and/or an implant to a surgical site
in the body of a patient. The instrumentation and/or the implant
can include, for example, a spinal implant system including a
spinal implant or spinal implants such as, for example, a
corpectomy device, and the spinal implant system can be implanted
into a section of the spine of the patient. The spinal implant
system may be employed with surgical procedures such as fusion,
non-fusion, and/or fixation treatments that employ implants to
restore the mechanical support function of the vertebrae of the
patient. These procedures can include, for example, corpectomy and
discectomy procedures Thus, the intervertebral space formed by
removal of one or more vertebral bodies and one or more discs, and
the spinal implant system is used to bridge the intervertebral
space between vertebral bodies bordering the intervertebral
space.
The spinal implant system can include one or more of an adjustable
end cap 10 as depicted in FIGS. 1-6, and possibly, a spinal implant
or spinal implants. The spinal implant, for example, can be a
corpectomy device 12 depicted in FIGS. 7-11. The end cap 10 can be
used with additional end caps 10 and/or a spinal implant or spinal
implants such as the corpectomy device 12. For example, multiple
end caps 10 can be stacked on top of one another, as depicted in
FIG. 6. Furthermore, the componentry of the spinal implant system
can be assembled outside of the body, in situ within the spine, or
a combination of outside and in situ assembly.
To illustrate, for example, the end cap 10 can be attached to a
first end of the corpectomy device 12, and a second end cap 10'
(identical to the end cap 10) can be attached to a second end of
the corpectomy device 12. Thus, one or more of the end caps 10 can
be attached to either end of a spinal implant such as, for example,
the corpectomy device 12. The spinal implant used with the end cap
10 can be unexpandable and expandable. Thus, while the corpectomy
device 12 depicted in FIGS. 7-11 is expandable, corpectomy devices
that are unexpandable can be used with one or more of the end caps
10. The dimensions and ultimate angularity of the spinal implant
system implanted into a patient can vary at least depending on the
size of the spinal implant, on whether the spinal implant is
expandable or unexpandable, the number of the end caps utilized,
and the angularity afforded by the spinal implant and the one or
more end caps.
The end cap 10, as depicted in FIGS. 1-6, includes a base portion
14 and a body portion 16. As discussed below, the base portion 14
can be attached to the corpectomy device 12, and the body portion
16 can be positioned and repositioned with respect to the base
portion 14 to afford adjustable angularity. That is, the body
portion 16 is adjustable between different angled orientations with
respect to the base portion 14.
As depicted in FIGS. 1A and 4-5, the base portion 14 includes a
lower portion 20 and an upper portion 22. As discussed below, the
lower portion 20 is attachable and detachable to the corpectomy
device 12. Furthermore, the upper portion 22 is attached to and
extends upwardly from the lower portion 20, and the upper portion
22 serves as a pedestal for supporting the body portion 16 on the
base portion 14.
The lower portion 20 includes a plate (or disc) portion 24, and the
plate portion 24 includes an upper surface 26 and a lower surface
28. Various sidewall portions 30 extend downwardly from the lower
surface 28, and at least two of the sidewall portions 30 include
tabs 32 formed thereon facilitating the attachment and detachment
of the end cap 10 to the second end cap 10' or the corpectomy
device 12. The sidewall portions 30 are spaced apart from one
another and include exterior surfaces 34 and interior surfaces 36.
The exterior surfaces 34 and an exterior surface 38 of the plate
portion 24 can be arcuate.
The lower surface 28 of plate portion 24 and the interior surfaces
36 of the sidewall portions 30 define a cavity C for receiving a
portion of the second end cap 10' or a portion of the corpectomy
device 12 therein. As discussed below, the tabs 32 facilitate
attachment and detachment of the end cap 10 to the portions of the
second end cap 10' or the corpectomy device 12 after these portions
are received in the cavity C. Furthermore, the lower surface 28 of
the plate portion 24 and interior surfaces 36 of the sidewall
portions 30 are used to contact the portions of the second end cap
10' or the corpectomy device 12 received in the cavity C to resist
movement of the end cap 10 with respect thereto. The sidewall
portions 30 including the tabs 32 can have a degree of resiliency
(or springiness) allowing passage of portions of the second end cap
10' or the corpectomy device 12 thereby. As such, the sidewall
portions including the tabs 32 serve in attaching and detaching the
end cap 10 to the second end cap 10' or the corpectomy device 12,
and the sidewall portions 30 serve in stabilizing the position of
the end cap 10 thereon.
The plate portion 24 includes various apertures 40 extending
between the upper surface 26 and the lower surface 28 that can
receive portions of the second end cap 10' or the corpectomy device
12. The apertures 40 are spaced apart from one another around the
plate portion 24, and the apertures 40 can include engagement
surfaces 42 adjacent the lower surface 28 for contacting
complementary engagement surfaces on the second end cap 10' or the
corpectomy device 12. The engagement surfaces 42 can have
frusto-conical shapes. Rather than the various apertures 40,
various depressions that incorporate the engagement surfaces 42 can
be formed in the lower surface 28.
As discussed below, the upper portion 22 serves as a pedestal for
supporting the body portion 16 on the base portion 14. The upper
portion 22 includes a first end 50, an opposite second end 52, and
an axis A.sub.1 extending through the first end 50 and the second
end 52. The first end 50 is attached to the plate portion 24, and
the upper portion 22 extends from the plate portion 24 to the
second end 52. As depicted in FIGS. 1A and 4-5, the upper portion
22 from the first end to adjacent the second end 52 includes an
exterior surface portion 54, and at and adjacent the second end 52
includes an exterior surface portion 56. The exterior surface
portion 54 can be substantially cylindrical, and the exterior
surface portion 56 can have a decreasing taper. The decreasing
taper, for example, can be formed by a plurality of steps 58
similar to those disclosed in U.S. Publication No. 2016/0100955,
which is hereby incorporated by reference herein in its
entirety.
The base portion 14 includes a passage 64 extending therethrough.
The passage 64 extends through the lower portion 20 and the upper
portion 22. The passage 64 includes a first opening 66 formed in
the lower surface 28 of the plate portion 24 of the lower portion
20, and includes a second opening 67 formed in the exterior surface
portion 56 of the second end 52 of the upper portion 22. The
passage 64 can be filled with bone growth promoting materials.
Thus, after implantation of the spinal implant system, the bone
growth promoting materials can stimulate bone growth through the
spinal implant system.
The plurality of steps 58 and the interior of the body portion 16
allow for selective positioning of the body portion 16 relative to
the base portion 14. As depicted in FIGS. 4A and 4B, such selective
positioning affords rotation of the body portion 16 relative to the
axis A.sub.1, and affords different angled orientations of the body
portion 16 relative to the base portion 14. A top surface 68 of the
body portion 16 can be angled at least in the range of .+-.10
degrees, if not more, relative to the axis A.sub.1. Alternatively,
an axis A.sub.2 of the body portion 16 can be angled at least in
the range of .+-.10 degrees, if not more, relative to the axis
A.sub.1. Furthermore, as discussed below, the body portion 16 can
be fixed in position relative to the base portion 14 using a
locking element 90 and a protrusion or nub 92 that impinge on a
first engagement surface 60 and a second engagement surface 62,
respectively, formed on the upper portion 22 similar to that
disclosed in U.S. Publication No. 2016/0100955.
The body portion 16 includes a sidewall portion 70 and a flange
portion 72. The sidewall portion 70 includes an exterior surface 74
that can be arcuate, and the radius of curvature of the exterior
surface 74 can be similar to the radii of curvatures of the
exterior surfaces 34 and the exterior surface 38. As depicted in
FIGS. 1 and 2-4, the exterior surface 74 can be cylindrical. The
sidewall portion 70 includes a recess 76 formed in the exterior
surface 74 adjacent the flange portion 72. As depicted in FIGS. 1
and 2-4, the recess 76 can be annular.
The sidewall portion 70 also includes an interior surface 78
defining an interior cavity 80, and the interior cavity 80 is
configured to receive a portion of the upper portion 22 of the base
portion 14. The interior surface 78 includes a lower portion 82
that surrounds a portion the exterior surface portion 54, and the
interior surface 78 includes an upper portion 84 for engaging the
exterior surface portion 56. The lower portion 82 can have a
frusto-conical shape, and the upper portion 84 can have a dome
shape. The frusto-conical shape of the lower portion 82 and the
dome shape of the upper portion 84 allow the body portion 16 to
rotate on the upper portion 22 relative to the base portion 14
between the above-discussed angles.
The locking element 90 and the protrusion 92 can be used in fixing
the body portion 16 in position relative to base portion 14. The
locking element 90 can be a fastener such as a set screw received
in an aperture 94 extending through the sidewall portion 70 of the
body portion 16. The aperture 94 includes threads that complement
the threads of the set screw 90, and the set screw 90 can be driven
through the aperture 94 to impinge on the first engagement surface
60. Additionally, the protrusion 92 can be a nub that extends into
the interior cavity 80 from the interior surface 78. The nub 92 can
be engaged to the second engagement surface 62. The first
engagement surface 60 and the second engagement surface 62 can be
provided on opposite or approximately opposite sides of the upper
portion 22, and the set screw 90 and the nub 92 can be provided on
opposite or approximately sides of the body portion. Thus,
impingement of the set screw 90 on the first engagement surface 60
causes impingement of the nub 92 on the second engagement surface
62. As such, the upper portion 22 can be clamped between the set
screw 90 and the nub 92 by tightening of the set screw 90 to fix
the body portion 16 in position relative to the base portion
14.
The flange portion 72 is configured to both engage bone of the
patient and engage portions of the second end cap 10'. The flange
portion 72 can engage an endplate of the vertebra of the patient,
or the flange portion 72 can facilitate attachment of the end cap
10 to the second end cap 10' via receipt thereof in the cavity C of
the second end cap 10'.
The flange portion 72 includes the top surface 68, an aperture 100
through the top surface 68, various protrusions 102 spaced apart
from one another around the flange portion 72, and a perimeter
surface 104 extending around the top surface 68. As depicted in
FIG. 1, the aperture 100 ultimately affords access to the passage
64, and the various protrusions 102 extend upwardly from various
recesses 106 formed in the top surface 68. The protrusions 102
include engagement surfaces 108 for either engaging the bone of the
endplate of the patient, or engaging the complementary engagement
surfaces 42 of the second end cap 10'. To illustrate, the
engagement of the protrusions 102 (along with the recesses 106) to
the bone of the endplate serves in resisting movement therebetween.
Furthermore, the engagement of the engagement surfaces 108 of the
end cap 10 with the engagement surfaces 42 of the second end cap
10' also serves in resisting movement therebetween.
To secure attachment therebetween, the flange portion 72 of the end
cap 10 can be received in the cavity C of the second end cap 10'.
In doing so, the engagement surfaces 108 of the end cap 10, as
discussed above, are engaged to engagement surfaces 42 of the
second end cap 10'. Furthermore, the top surface 68 of the end cap
10 is contacted with the lower surface 28 of the second end cap
10', portions of the perimeter surface 104 of the end cap 10 are
contacted to the interior surfaces 36 of the sidewall portions 30
of the second end cap 10', and the recess 76 of the end cap 10 can
receive the tabs 32 of the second end cap 10'.
As discussed above, the sidewall portions 30 including the tabs 32
have a degree of resiliency. Such resiliency allows the sidewall
portions 30 including the tabs 32 to move between a first position
and a second position, while being biased in the first position. As
such, the sidewall portions 30 including the tabs 32 allow passage
of the flange portion 72 thereby via movement thereof from the
first position to the second position. Thereafter, the bias thereof
moves the sidewall portions 30 including the tabs 32 back into the
first position. The resiliency of the sidewall portions 30
including the tabs 32 allows the end cap 10 to be rocked (via the
application of a rocking force) or snapped (via application of a
linear force) into position on the second end cap 10'. When the
sidewall portions 30 including the tabs 32 are in the first
position, the tabs 32 can be received in the recess 76 to attach
the end cap 10 to the second end cap 10'. Attachment can also be
accomplished utilizing attachment mechanisms similar to those
disclosed in U.S. Pat. No. 9,427,325, which is hereby incorporated
by referenced herein in its entirety.
As depicted in FIG. 6, a third end cap 10'' (identical to the end
cap 10) can be attached to the second end cap 10', and a fourth end
cap 10' (identical to the end cap 10) to the third end cap 10'' in
a similar manner to the attachment of the second end cap 10' to the
end cap 10. As such, various end caps 10 can be stacked on top of
one another. The stacking of additional end caps 10 increases the
height of the assembly and also increases the potential angularity
of the assembly.
Additionally, the cavities C of the end cap 10 or the second end
cap 10' can receive a first flange portion 110 or a second flange
portion 112 of an expandable spinal implant such as, for example,
the corpectomy device 12. The corpectomy device 12 is similar to
that disclosed in U.S. Publication No. 2016/0100955. Like the
device disclosed in U.S. Publication No. 2016/0100955, the overall
height of the corpectomy device 12 is adjustable between an
unexpanded configuration and an expanded configuration, and at
least one end of the corpectomy device includes features affording
adjustable angularity. However, an unexpandable spinal implant such
a corpectomy device having a fixed height and a fixed angularity
could also be used.
As depicted in FIGS. 7 and 8, the corpectomy device 12 includes a
first end 114 at which the first flange portion 110 is provided,
and includes an opposite second end 116 at which the second flange
portion 112 is provided. A first recess 120 is provided adjacent
the first flange portion 110, and a second recess 122 is provided
adjacent the second flange portion 112. The first flange portion
110, the second flange portion 112, the first recess 120, and the
second recess 122 could also be included on a fixed height spinal
implant (such as, for example, a corpectomy device) in similar
fashion. The first flange portion 110 and the second flange portion
112 are similar (if not identical) to the flange portion 72 of the
end cap 10. FIGS. 8 and 9 depict, for example, the end cap 10 being
positioned for attachment to the first flange portion 110.
Furthermore, the end cap 10 can be attached to one of the first
flange portion 110 and the second flange portion 112, and the
second end cap 10' can be attached to the other of the first flange
portion 110 and the second flange portion 112. As depicted in FIGS.
10 and 11, the end cap 10 is attached to the first flange portion
110 and the second end cap 10' is attached to the second flange
portion 112.
While FIG. 10 depicts the end cap 10' being rocked into position
via rocking force applied thereto, the end caps 10 and 10' can be
snapped onto the first flange portion 110 and the second portion
112 via the application of linear force thereto. The sidewall
portions 30 including tabs 32 formed thereon, as discussed above,
include a degree of resiliency to facilitate the attachment of the
end cap 10 and the end cap 10' via rocking and/or snapping thereon.
Furthermore, the third end cap 10'' and/or the fourth end cap 10''
can stacked onto the end cap 10 or the second end cap 10' in
similar fashion. Thus, the height and angularity of the spinal
implant system implanted into a patient can vary at least depending
on the size of the corpectomy device, on whether the corpectomy
device is expandable or unexpandable, the number of the end caps
utilized, and the angularity afforded by the one or more end caps
and the corpectomy device.
The corpectomy device 12 includes a passage 124 extending between
the first end 114 and the second end 116 thereof. The passage 124
includes a first opening 126 in the first flange portion 110 at the
first end 114 and a second opening (not shown) in the second flange
portion 112 at the second end 116. Furthermore, the passage 124,
like the passage 64 of the end cap 10, can be filled with bone
growth promoting materials. Thus, when one or more end caps 10 are
attached to the corpectomy device 12, the passage(s) 64 and the
passage 124 can communicate with one another. As such, after
implantation of the spinal implant system, the bone growth
promoting materials provided in the passage 64 and the passage 124
can be used to promote bone growth between the vertebral bodies
bordering the intervertebral space. Thus, after implantation of the
spinal implant system, the bone growth promoting materials can
stimulate bone growth through the spinal implant system.
The spinal implant system can employ one or more of the end caps 10
and a spinal implant such as, for example, the corpectomy device 12
is for implantation into a section of the spine of the patient. The
intervertebral space can be formed by removal of one or more
vertebral bodies and one or more discs, and the spinal implant
system is used to bridge the intervertebral space between the
vertebral bodies bordering the intervertebral space. When using the
spinal implant system of the present invention, the distance and
the angularity between the vertebral bodies bordering the
intervertebral space is determined. A corpectomy device 12 having
an appropriate height, and one or more of the end caps 10 can be
attached to either end of the corpectomy device 12 to provide a
height of the spinal implant system sized in accordance with the
distance between the vertebral bodies bordering the intervertebral
space. Furthermore, angularity of the end caps 10 can be adjusted
to accommodate the angularity between the vertebral bodies
bordering the intervertebral space. The height of the spinal
implant system also can be adjusted via use of an expandable, as
opposed to an unexpandable, spinal implant, and the angularity of
the spinal implant system also can be adjusted using a spinal
implants including features affording adjustable angularity.
Furthermore, the spinal implant system can employ one or more of
the end caps 10 and a plurality of spinal implants such as, for
example, a plurality of the corpectomy devices. For example, at
least one of the end caps 10 can be used with at least two
corpectomy devices. To illustrate, the end cap 10 could be
positioned between a first one and a second one of the corpectomy
devices. The end cap 10 could be attached to a first corpectomy
device such as, for example, the corpectomy device 12 via receipt
of the first flange portion 110 of the corpectomy device 12 in the
cavity C of the end cap 10. Furthermore, a second corpectomy device
could be modified to have structure providing a cavity similar to
the cavity C of the end cap 10, and the end cap 10 could be
attached to the second corpectomy device via receipt of the flange
portion 72 in the cavity of the second corpectomy device. Rather
than modifying the second corpectomy to have structure providing a
cavity similar to the cavity C of the end cap 10, the end cap 10
could be modified to include structure providing a second cavity
similar to the cavity C instead of the flange 72, and the first
flange 110 of the first corpectomy device could be received in the
cavity C, and the second flange 112 of the second corpectomy device
could be received in the second cavity similar to cavity C.
Alternatively, the end cap 10 could be modified to include
structure providing a second flange similar to flange 72 instead of
the cavity C, the first corpectomy device and the second corpectomy
device could be modified to have structure providing cavities
similar to the cavity C, and the flange 72 could be received in the
cavity of the first corpectomy device, and the second flange
similar to flange 72 could received in the cavity of the second
corpectomy devices. Other types of implants can be similarly
modified. Additionally, additional end caps 10 and additional
spinal implants could be modified and attached to one another in
similar fashion.
Other embodiments of the invention will be apparent to those
skilled in the art from consideration of the specification and
practice of the invention disclosed herein. It is intended that the
specification and examples be considered as exemplary only, with a
true scope and spirit of the invention being indicated by the
following claims.
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